| Regimental number | 5416 |
| Place of birth | Hill End New South Wales |
| Religion | Methodist |
| Occupation | Railway fettler |
| Address | Leederville, Western Australia |
| Marital status | Single |
| Age at embarkation | 43 |
| Next of kin | Cousin, Miss Ivy Chappell, Leederville, Western Australia |
| Enlistment date | 13 February 1916 |
| Rank on enlistment | Private |
| Unit name | 28th Battalion, 14th Reinforcement |
| AWM Embarkation Roll number | 23/45/3 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A28 Miltiades on 7 August 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 28th Battalion |
| Fate | Returned to Australia 22 July 1917 |